title: Neuropsychological, clinical and cognitive insight predictors of outcome in a first episode psychosis study.
abstract: The outcome of first episode psychosis (FEP) is highly variable and difficult to predict. We studied prospectively the impact of poor insight and neuropsychological deficits on outcomes in a longitudinal cohort of 127 FEP patients. Participants were assessed on 5 domains of cognitive function and 2 domains of insight (clinical and cognitive). At 12 months, patients were assessed again for symptom severity and psychosocial function. Regression analyses revealed that cognitive insight (a measure of self-reflectiveness and self-certainty) was the best baseline predictor of overall psychopathology at 12 months whereas executive function performance at admission to the study indicated later severity of negative symptoms. Other neuropsychological and insight measures were poor predictors of psychosocial function at 1 year. The results suggest that specific neuropsychological and insight factors have separate predictive capacities indicating that they are distinct psychological processes in psychosis. Cognitive insight proved to be a useful prognostic indicator, and should be considered for future studies and as a potential focus for treatment.
authors.affiliation: Department of Psychosis Studies, P068, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom. jennifer.1.o'connor@kcl.ac.uk
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: O'Connor
authors.forename: Benjamin
authors.initials: B
authors.lastname: Wiffen
authors.forename: Marta
authors.initials: M
authors.lastname: Diforti
authors.forename: Laura
authors.initials: L
authors.lastname: Ferraro
authors.forename: Candice
authors.initials: C
authors.lastname: Joseph
authors.forename: Anna
authors.initials: A
authors.lastname: Kolliakou
authors.forename: Stefania
authors.initials: S
authors.lastname: Bonaccorso
authors.forename: Robin M
authors.initials: RM
authors.lastname: Murray
authors.forename: Anthony S
authors.initials: AS
authors.lastname: David
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012044:Regression Analysis; D055815:Young Adult
keywords: First episode psychosis; Insight; Neuropsychology; Recovery